nach oben

Erschienen in:

28.05.2019 | Epidemiology

The use of contralateral prophylactic mastectomy among elderly patients in the United States

verfasst von: Schelomo Marmor, Ariella M. Altman, William T. Mayleben, Jane Y. C. Hui, Jason W. Denbo, Eric H. Jensen, Todd M. Tuttle

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Previous studies have reported increased rates of contralateral prophylactic mastectomy (CPM) in the United States among women with unilateral breast cancer. These trends have primarily focused on younger breast cancer patients. Given the growing aging population in the United States, we sought to determine whether CPM use is also increasing in elderly patients.

Methods

This population-based study identified patients in the surveillance epidemiology and end results (SEER) data. We determined the rate of CPM as a proportion of all surgically treated patients and as a proportion of all mastectomies. We compared the unadjusted CPM rates over the study period using the Cochrane-Armitage test for trend. We used a logistic regression model to test for the factors associated with CPM utilization.

Results

We identified 261,281 patients ≥ 65 years who underwent surgical treatment for breast cancer. For all patients treated with surgery for invasive breast cancer, the use of CPM increased from 1 in 2004 to 3% in 2014 (200% increase). Among mastectomy patients, the use of CPM increased from 3 in 2004 to 7% in 2014 (133% increase). Young age, non-Hispanic white race, lobular histology, higher grade, increased stage, negative lymph node status, and recent year of diagnosis were significantly associated with increased CPM rates.

Conclusions

For elderly patients the use of CPM has continued to increase in the United States. These observations warrant concern in light of increasing evidence that CPM does not improve oncological outcomes and is associated with increased morbidity in older patients.

Tuttle TM, Habermann EB, Grund EH et al (2007) Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol 25:5203–5209CrossRefPubMed

King TA, Sakr R, Patil S et al (2011) Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol 29(16):2158–2164CrossRefPubMed

Yao K, Stewart AK, Winchester DJ, Winchester DP (2010) Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998–2007. Ann Surg Oncol 17(10):2554–2562CrossRefPubMed

McLaughlin CC, Lillquist PP, Edge SB (2009) Surveillance of prophylactic mastectomy: trends in use from 1995 through 2005. Cancer 115:5404–5412CrossRefPubMed

Jones NB, Wilson J, Kotur L et al (2009) Contralateral prophylactic mastectomy for unilateral breast cancer: an increasing trend at a single institution. Ann Surg Oncol 16:2691–2696CrossRefPubMed

National Comprehensive Cancer Network (2014) NCCN clinical practice guidelines in oncology: breast cancer risk reduction. Version 1. http://www.nccn.org/professionals/physician_gls/pdf/breast_risk.pdf. Accessed 2 Apr 2015

Cardoso F, Kyriakides S, Penault-Llorca F et al (2013) Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):vi7–vi23PubMed

Portschy PR, Kuntz KM, Tuttle TM (2014) Survival outcomes after contralateral prophylactic mastectomy: a decision analysis. J Natl Cancer Inst 106(8):dju160CrossRefPubMed

Kurian AW, Lichtensztajn DY, Keegan TH et al (2014) Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998–2011. JAMA 312(9):902–914CrossRefPubMedPubMedCentral

10.

Deshmukh AA, Cantor SB, Crosby MA et al (2014) Cost of contralateral prophylactic mastectomy. Ann Surg Oncol 21:2823–2830CrossRefPubMedPubMedCentral

11.

Wood WC (2009) Should the use of contralateral prophylactic mastectomy be increasing as it is? Breast 18:S93–S95CrossRefPubMed

12.

Newman LA (2014) Contralateral prophylactic mastectomy: is it a reasonable option? JAMA 312(9):895–897CrossRefPubMed

13.

Orenstein P (2014) The wrong approach to breast cancer. The New York Times. http://www.nytimes.com/2014/07/27/opinion/sunday/the-wrong-approach-to-breast-cancer.html?_r=0. Accessed 6 June 2018

14.

American Society of Breast Surgeons. American Society of Breast Surgeons Consensus Panel Recommends Against Routine Use of Contralateral Prophylactic Mastectomy. https://www.breastsurgeons.org/docs/ASBrS_CPM_PositionStatement.pdf. Accessed 28 July 2016

15.

Cyr A, Gillanders WE, Aft RL, Eberlein TJ, Margenthaler JA (2011) Breast cancer in elderly women (≥ 80 years): variation in standard of care? J Surg Oncol 103(3):201–206CrossRefPubMed

16.

Biganzoli L, Wildiers H, Oakman C, Marotti L, Loibl S, Kunkler I, Reed M et al (2012) Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA). Lancet Oncol 13(4):e148–e160CrossRefPubMed

17.

Gao X, Fisher SG, Emami B (2003) Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: a population-based study. Int J Radiat Oncol Biol Phys 56(4):1038–1045CrossRefPubMed

18.

Osman F, Saleh F, Jackson TD et al (2013) Increased postoperative complications in bilateral mastectomy patients compared to unilateral mastectomy: an analysis of the NSQIP database. Ann Surg Oncol 20(10):3212–3217CrossRefPubMed

19.

Han E, Johnson N, Glissmeyer M et al (2011) Increasing incidence of bilateral mastectomies: the patient perspective. Am J Surg 201(5):615–618CrossRefPubMed

20.

Vuoto HD, García AM, Candás GB, Zimmermann AG, Uriburu JL, Isetta JA, Cogorno L, Khoury M, Bernabó OL (2010) Bilateral breast carcinoma: clinical characteristics and its impact on survival. Breast J 16(6):625–632CrossRefPubMed

21.

Hawley ST, Jagsi R, Morrow M et al (2014) Social and clinical determinants of contralateral prophylactic mastectomy. JAMA Surg 149:582CrossRefPubMedPubMedCentral

22.

Sparano JA, Gray RJ, Makower DF, Pritchard KI, Albain KS, Hayes DF, Geyer CE Jr, Dees EC, Goetz MP, Olson JA Jr, Lively T (2018) Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med 379(2):111–121CrossRefPubMedPubMedCentral

23.

Early Breast Cancer Trialists’ Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365(9472):1687–1717CrossRef

24.

Boughey JC, Attai DJ, Chen SL, Cody HS, Dietz JR, Feldman SM, Greenberg CC, Kass RB, Landercasper J, Lemaine V, MacNeill F (2016) Contralateral prophylactic mastectomy (CPM) consensus statement from the American Society of Breast Surgeons: data on CPM outcomes and risks. Ann Surg Oncol 23(10):3100–3105CrossRefPubMedPubMedCentral

25.

Fredholm H, Eaker S, Frisell J, Holmberg L, Fredriksson I, Lindman H (2009) Breast cancer in young women: poor survival despite intensive treatment. PLoS ONE 4(11):e7695CrossRefPubMedPubMedCentral

26.

Gnerlich JL, Deshpande AD, Jeffe DB, Sweet A, White N, Margenthaler JA (2009) Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. J Am Coll Surg 208(3):341–347CrossRefPubMedPubMedCentral

27.

Azim HA, Partridge AH (2014) Biology of breast cancer in young women. Breast Cancer Res 16(4):427CrossRefPubMedPubMedCentral

28.

Jenkins EO, Deal AM, Anders CK, Prat A, Perou CM, Carey LA, Muss HB (2014) Age-specific changes in intrinsic breast cancer subtypes: a focus on older women. Oncologist 19(10):1076–1083CrossRefPubMedPubMedCentral

29.

Greenup R, Buchanan A, Lorizio W, Rhoads K, Chan S, Leedom T, King R, McLennan J, Crawford B, Marcom PK, Hwang ES (2013) Prevalence of BRCA mutations among women with triple-negative breast cancer (TNBC) in a genetic counseling cohort. Ann Surg Oncol 20(10):3254–3258CrossRefPubMed

30.

Shachar SS, Hurria A, Muss HB (2016) Breast cancer in women older than 80 years. J Oncol Pract 12(2):123–132CrossRefPubMed

31.

De Glas NA, Kiderlen M, Bastiaannet E, de Craen AJM, van de Water W, van de Velde CJH, Liefers GJ (2013) Postoperative complications and survival of elderly breast cancer patients: a FOCUS study analysis. Breast Cancer Res Treat 138(2):561–569CrossRefPubMed

32.

Agarwal S, Kidwell KM, Kraft CT et al (2015) Defining the relationship between patient decisions to undergo breast reconstruction and contralateral prophylactic mastectomy. Plast Reconstr Surg 135(3):661–670CrossRefPubMedPubMedCentral

33.

Elsayegh N, Webster RD, Gutierrez Barrera AM, Lin H, Kuerer HM, Litton JK, Bedrosian I, Arun BK (2018) Contralateral prophylactic mastectomy rate and predictive factors among patients with breast cancer who underwent multigene panel testing for hereditary cancer. Cancer Med 7(6):2718–2726CrossRefPubMedPubMedCentral

34.

35.

Early Breast Cancer Trialists’ Collaborative G, Davies C, Godwin J et al (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–784CrossRef

36.

Nichols HB, de Gonzalez AB, Lacey JV Jr, Rosenberg PS, Anderson WF (2011) Declining incidence of contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol 29(12):1564–1569CrossRefPubMedPubMedCentral

37.

Sorbero ME, Dick AW, Burke Beckjord E et al (2009) Diagnostic breast magnetic resonance imaging and contralateral prophylactic mastectomy. Ann Surg Oncol 16:1597–1605CrossRefPubMed

38.

Yi M, Hunt KK, Arun BK et al (2010) Factors affecting the decision of breast cancer patients to undergo contralateral prophylactic mastectomy. Cancer Prev Res 3(8):1026–1034CrossRef

39.

Lostumbo L, Carbine N, Wallace J et al (2004) Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev 4:CD002748

40.

Society of Surgical Oncology: statement on prophylactic mastectomy. http://www.surgonc.org/default.asp?id47. Accessed 1 Dec 2019

41.

Abbott A, Rueth N, Pappas-Varco S et al (2011) Perceptions of contralateral breast cancer: an overestimation of risk. Ann Surg Oncol 18(11):3129–3136CrossRefPubMed

42.

Rosenberg SM, Tracy MS, Meyer ME et al (2013) Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: a cross-sectional survey. Ann Intern Med 159(6):373–381CrossRefPubMedPubMedCentral

Titel: The use of contralateral prophylactic mastectomy among elderly patients in the United States
verfasst von: Schelomo Marmor
Ariella M. Altman
William T. Mayleben
Jane Y. C. Hui
Jason W. Denbo
Eric H. Jensen
Todd M. Tuttle
Publikationsdatum: 28.05.2019
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 1/2019
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-019-05288-8

Springer Medizin

The use of contralateral prophylactic mastectomy among elderly patients in the United States